Provider Demographics
NPI:1811983034
Name:COHEN, TODD (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:120 MINEOLA BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4073
Mailing Address - Country:US
Mailing Address - Phone:516-663-8530
Mailing Address - Fax:516-663-8546
Practice Address - Street 1:NORTHERN BLVD AT VALENTINES LANE
Practice Address - Street 2:RILAND HEALTHCARE CENTER - NYIT
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568
Practice Address - Country:US
Practice Address - Phone:516-287-8898
Practice Address - Fax:516-730-9569
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY165465207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01380827Medicaid
NYF29445Medicare UPIN
NY01380827Medicaid